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Factors Associated with Ketamine Use in Pancreatic Cancer Patient in a Single Hospice Center

  • Kwon, Kyung Min;Lee, Yong Joo;Choi, Chang Jin;Kim, Chul Min;Yoon, Jo Hi;Kim, Min Hee
    • Journal of Hospice and Palliative Care
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    • v.19 no.3
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    • pp.249-255
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    • 2016
  • Purpose: Up to 90% of pancreatic cancer patients suffer from neuropathic pain. In a palliative care setting, pain control in pancreatic cancer patient is one of the major goals. Ketamine is a N-methyl-D-aspartate (NMDA) receptor antagonist, effective in neuropathic pain. Additionally, there have been studies about the opioid sparing effect of ketamine. This study was held in the palliative care unit among pancreatic cancer patients to determine the factors related to ketamine use and the opioid sparing effect. Methods: The medical records of pancreatic cancer patients admitted to St. Mary's hospital palliative care unit between January, 2013 and December, 2014 were reviewed. Patients were divided into 2 categories according to ketamine use. Also, opioid use before and after ketamine use was compared in the ketamine group. Results: Compared to the non-ketamine use group, patients in the ketamine group required a higher dose of opioid. The total opioid dose, daily opioid dose, number of daily rescue medications, and daily average rescue dose were statistically significantly higher in the ketamine group. The opioid requirement was increased after ketamine administration. Conclusion: In this retrospective study, ketamine was frequently considered in patients with severe pain, requiring higher amount of opioid. Studies about palliative use of ketamine in a larger number of patients with diverse types of cancer pain are required in the future.

Clinicopathological Analysis of Glomerulonephritis in Children (소아 사구체신염의 임상 및 병리학적 분석)

  • Park Gwang-Yong;Yoon Hye-Kyoung;Chung Woo-Yeong
    • Childhood Kidney Diseases
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    • v.1 no.1
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    • pp.4-12
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    • 1997
  • Purpose: To evaluate the prevalence and clinical manifestations of various glomerulonephritis (GN) in children, a clinicopathological anlysis of 310 biopsied cases were performed. Method: We conducted retrospective study with review of histopathologic findings and clinical manifestations of the 310 cases diagnosed as glomerulonephritis by percutaneous renal biopsy which were done between January 1986 and December 1996 at department of pediatrics, Pusan Paik hospital. Results: 1) Male to female ratio was 1.54:1 and the range of age was from 13 months to 15 years 10 months. 2) Among these, 217 (70.0%) patients were belong to primary GN and 93 (30.0%) patients were belong to secondary GN. As a whole, the most common pathologic diagnosis was minimal change lesion (MC, 32.6%), which was followed by IgA nephropathy (IgAN, 15.8%), $Henoch-Sch\"{o}nlein$ purpura nephritis (HSPN, 13.5%), Poststreptococcal glomerulonephritis (PSAGN, 8.1%). 3) Clinical manifestations of patients were asymptomatic urinary abnormality (43.2%), nephrotic syndrome (41.0%), acute glomerulonephritis (14.2%), chronic glomerulonephritis (1.0%), rapidly progressive glomerulonephritis (0.6%). 4) In primary GN, the most common pathologic diagnosis was MC (46.5%), IgAN (22.6%), thin glomerular basement membrane (GBM) disease (7.8%), membranoproliferative glomerulonephritis (MPGN, 5.5%), mesangial proliferative glomerulonephritis (MesPGN,4.6%), focal segmental glomerulosclerosis (FSGS, 4.6%), membranous nephropathy (MN, 0.9%), sclerosing glomerulonephritis (SCGN, 0.9%), crescentic glomerulonephritis (CreGN, 0.5%) and non-specific glomerulonephritis (NonspGN, 6.0%). 5) Major causes of secondary GN were HSPN (45.2%), PSAGN (26.9%), hepatitis B associated glomerulonephritis (HBGN, 17.2%), lupus nephritis (LN, 6.5%), Alport syndrome (2.2%), hemolytic uremic syndrome (1.0%), fibrillary glomerulonephritis (1.0%) in descending order. Conclusions: There are some differences of the results of clinicopathological stuidies of glomerulonephritis in children because of its different indications of renal biopsy, pathologic classification of renal disease and methods of analysis among investigators. In order to establish more reliable data of incidence and classification of childhood glomerulonephritis in Korea, multicenter cooperative study were necessary.

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Analysis of HACCP System Implementation on Productivity, Advantage and Disadvantage of Laying Hen Farm in Korea (산란계 농장의 HACCP 제도 적용에 따른 생산성과 장단점 분석)

  • Nam, In Sik;Kim, Hyung Sik;Seo, Kang Min;Ahn, Jong Ho
    • Korean Journal of Poultry Science
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    • v.41 no.2
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    • pp.93-98
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    • 2014
  • This study was conducted to analysis the reason for implementing HACCP system, advantage and disadvantage of HACCP system implemented laying hen farm. The study was carried out by randomly selected fifteen laying hen farms located in all around Korea. All data were collected from fifteen laying hen farms before and after the implementation of HACCP system. The results were as follows: The egg production rate, livability rate and monthly used animal medicine fee did not changed after HACCP system implementation. However, monthly used disinfectant fee tended to be higher in HACCP farm compared to non-HACCP farm. 26.92% of the laying hen farmer responded enhancement of their farm competitiveness as the major propose for implementing HACCP system. The advantages of HACCP implemented laying hen farms were methodical farm management (22.39%), improvement of awareness (21.18%), improvement of the farm sanitation management level (15.30%), safety egg production (15.05%), productivity enhancement (7.29%), reduction of mortality rate (6.82%), and improvement of labor's welfare (5.89%). The disadvantages of HACCP implemented laying hen farms were HACCP recording (43.30%), alteration of consciousness (22.60%), HACCP monitoring (11.11%), HACCP education (9.97%), HACCP verification (6.90%), and A high turnover of labor (6.13%). In conclusion, implementation of HACCP system to laying hen farm did not affect on the productivity or the use of animal medicine. However, the HACCP system may enhance safety and sanitation of egg production for consumer.

Prosodic Phrasing and Focus in Korea

  • Baek, Judy Yoo-Kyung
    • Proceedings of the KSPS conference
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    • 1996.10a
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    • pp.246-246
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    • 1996
  • Purpose: Some of the properties of the prosodic phrasing and some acoustic and phonological effects of contrastive focus on the tonal pattern of Seoul Korean is explored based on a brief experiment of analyzing the fundamental frequency(=FO) contour of the speech of the author. Data Base and Analysis Procedures: The examples were chosen to contain mostly nasal and liquid consonants, since it is difficult to track down the formants in stops and fricatives during their corresponding consonantal intervals and stops may yield an effect of unwanted increase in the FO value due to their burst into the following vowel. All examples were recorded three times and the spectrum of the most stable repetition was generated, from which the FO contour of each sentence was obtained, the peaks with a value higher than 250Hz being interpreted as a high tone (=H). The result is then discussed within the prosodic hierarchy framework of Selkirk (1986) and compared with the tonal pattern of the Northern Kyungsang dialect of Korean reported in Kenstowicz & Sohn (1996). Prosodic Phrasing: In N.K. Korean, H never appears both on the object and on the verb in a neutral sentence, which indicates the object and the verb form a single Phonological Phrase ($={\phi}$), given that there is only one pitch peak for each $={\phi}$. However, Seoul Korean shows that both the object and the verb have H of their own, indicating that they are not contained in one $={\phi}$. This violates the Optimality constraint of Wrap-XP (=Enclose a lexical head and its arguments in one $={\phi}$), while N.K. Korean obeys the constraint by grouping a VP in a single $={\phi}$. This asymmetry can be resolved through a constraint that favors the separate grouping of each lexical category and is ranked higher than Wrap-XP in Seoul Korean but vice versa in N.K. Korean; $Align-x^{lex}$ (=Align the left edge of a lexical category with that of a $={\phi}$). (1) nuna-ka manll-ll mEk-nIn-ta ('sister-NOM garlic-ACC eat-PRES-DECL') a. (LLH) (LLH) (HLL) ----Seoul Korean b. (LLH) (LLL LHL) ----N.K. Korean Focus and Phrasing: Two major effects of contrastive focus on phonological phrasing are found in Seoul Korean: (a) the peak of an Intonatioanl Phrase (=IP) falls on the focused element; and (b) focus has the effect of deleting all the following prosodic structures. A focused element always attracts the peak of IP, showing an increase of approximately 30Hz compared with the peak of a non-focused IP. When a subject is focused, no H appears either on the object or on the verb and a focused object is never followed by a verb with H. The post-focus deletion of prosodic boundaries is forced through the interaction of StressFocus (=If F is a focus and DF is its semantic domain, the highest prominence in DF will be within F) and Rightmost-IP (=The peak of an IP projects from the rightmost $={\phi}$). First Stress-F requires the peak of IP to fall on the focused element. Then to avoid violating Rightmost-IP, all the boundaries after the focused element should delete, minimizing the number of $={\phi}$'s intervening from the right edge of IP. (2) (omitted) Conclusion: In general, there seems to be no direct alignment constraints between the syntactically focused element and the edge of $={\phi}$ determined in phonology; all the alignment effects come from a single requirement that the peak of IP projects from the rightmost $={\phi}$ as proposed in Truckenbrodt (1995).

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Colonization Rate and Control of Vancomycin-Resistant Enterococci in the Neonatal Intensive Care Unit (일개 신생아중환자실 반코마이신 저항 장구균(VRE)의 유행 양상과 조절)

  • Seo, Jung Ho;Nam, Ga Yeon;Park, Kyung Hee;Byun, Shin Yun;Park, Su Eun
    • Pediatric Infection and Vaccine
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    • v.17 no.1
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    • pp.1-8
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    • 2010
  • Purpose : Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). Methods : We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. Results : The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. Conclusion : VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.

Corporate Bond Rating Using Various Multiclass Support Vector Machines (다양한 다분류 SVM을 적용한 기업채권평가)

  • Ahn, Hyun-Chul;Kim, Kyoung-Jae
    • Asia pacific journal of information systems
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    • v.19 no.2
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    • pp.157-178
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    • 2009
  • Corporate credit rating is a very important factor in the market for corporate debt. Information concerning corporate operations is often disseminated to market participants through the changes in credit ratings that are published by professional rating agencies, such as Standard and Poor's (S&P) and Moody's Investor Service. Since these agencies generally require a large fee for the service, and the periodically provided ratings sometimes do not reflect the default risk of the company at the time, it may be advantageous for bond-market participants to be able to classify credit ratings before the agencies actually publish them. As a result, it is very important for companies (especially, financial companies) to develop a proper model of credit rating. From a technical perspective, the credit rating constitutes a typical, multiclass, classification problem because rating agencies generally have ten or more categories of ratings. For example, S&P's ratings range from AAA for the highest-quality bonds to D for the lowest-quality bonds. The professional rating agencies emphasize the importance of analysts' subjective judgments in the determination of credit ratings. However, in practice, a mathematical model that uses the financial variables of companies plays an important role in determining credit ratings, since it is convenient to apply and cost efficient. These financial variables include the ratios that represent a company's leverage status, liquidity status, and profitability status. Several statistical and artificial intelligence (AI) techniques have been applied as tools for predicting credit ratings. Among them, artificial neural networks are most prevalent in the area of finance because of their broad applicability to many business problems and their preeminent ability to adapt. However, artificial neural networks also have many defects, including the difficulty in determining the values of the control parameters and the number of processing elements in the layer as well as the risk of over-fitting. Of late, because of their robustness and high accuracy, support vector machines (SVMs) have become popular as a solution for problems with generating accurate prediction. An SVM's solution may be globally optimal because SVMs seek to minimize structural risk. On the other hand, artificial neural network models may tend to find locally optimal solutions because they seek to minimize empirical risk. In addition, no parameters need to be tuned in SVMs, barring the upper bound for non-separable cases in linear SVMs. Since SVMs were originally devised for binary classification, however they are not intrinsically geared for multiclass classifications as in credit ratings. Thus, researchers have tried to extend the original SVM to multiclass classification. Hitherto, a variety of techniques to extend standard SVMs to multiclass SVMs (MSVMs) has been proposed in the literature Only a few types of MSVM are, however, tested using prior studies that apply MSVMs to credit ratings studies. In this study, we examined six different techniques of MSVMs: (1) One-Against-One, (2) One-Against-AIL (3) DAGSVM, (4) ECOC, (5) Method of Weston and Watkins, and (6) Method of Crammer and Singer. In addition, we examined the prediction accuracy of some modified version of conventional MSVM techniques. To find the most appropriate technique of MSVMs for corporate bond rating, we applied all the techniques of MSVMs to a real-world case of credit rating in Korea. The best application is in corporate bond rating, which is the most frequently studied area of credit rating for specific debt issues or other financial obligations. For our study the research data were collected from National Information and Credit Evaluation, Inc., a major bond-rating company in Korea. The data set is comprised of the bond-ratings for the year 2002 and various financial variables for 1,295 companies from the manufacturing industry in Korea. We compared the results of these techniques with one another, and with those of traditional methods for credit ratings, such as multiple discriminant analysis (MDA), multinomial logistic regression (MLOGIT), and artificial neural networks (ANNs). As a result, we found that DAGSVM with an ordered list was the best approach for the prediction of bond rating. In addition, we found that the modified version of ECOC approach can yield higher prediction accuracy for the cases showing clear patterns.

Fruiting body development and genetic analysis of somatic hybrids by protoplast fusion in edible fungi (식용버섯의 원형질체 융합체의 자실체 발생 및 유전분석)

  • Yoo, Young Bok;Kong, Won Sik;Oh, Se Jong;Jhune, Chang Sung;Shin, Pyung Gyun;Kim, Beom Gi;Kim, Gyu Hyun;Park, Minsun;Min, Byung Re
    • Journal of Mushroom
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    • v.2 no.3
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    • pp.115-126
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    • 2004
  • Somatic hybrids of inter-compatible and inter-incompatible strains were obtained by protoplast fusion. The fusion products between compatible strains, Pleurotus ostreatus and P. florida, formed heterokaryons, while fusants between incompatible strains such as P. cornucopiae + P. florida, P. ostreatus + Ganoderma applanatum, P. florida + Ganoderma lucidum, and P. ostreatus + Flammulina velutipes formed synkaryons that retained genes from both parents. The heterokaryons showed the same level of basidioma development. In contrast, the synkaryons showed unique characteristics including clamp connection formation at mitosis, either partner basidioma development, and abnormal segregation and recombination compared with inter-compatible strains. Synkaryons can be classified into homokaryoyic and heterokaryotic type. A comparison of somatic hybrids with compatible and incompatible strains was made using random amplified polymorphic DNA (RAPD) analysis. The heterokaryons between compatible species showed the same level of variability and contained both parental RAPD bands. In contrast, most of the synkaryons between incompatible species showed similarity to those of either parental bands and non-parental RAPD bands. Synkaryons can be classified into microgenome insertion type and macrogenome insertion type. A tetrapolar mating system was found among monospore isolates in somatic hybrids and wild type P. ostreatus. Homokaryons from each somatic hybrid combination were paired with tester homokaryons of the initial wild type of P. ostreatus. The changed mating types were identified in progenies. The pattern of mating type switching in somatic hybrids depends on compatibility of fusion partner. There are several factors related to the mechanism of clamp connection formation and fruiting body development of synkaryons. Of these,the major factor may be associated with self-fertility and mating type switching such as homokaryotic fruiting of wild type P. ostreatus. This review will discuss these aspects.

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Effect of High Protein Diet and Resveratrol Supplementation on the Nutritional Status and Immunoreactivity in the Irradiation-induced Inflammatory Rats (방사선 조사된 흰쥐에서 고단백식이와 레스베라트롤 첨가가 영양상태 및 면역기능 증진에 미치는 효과)

  • Kim, Kyoung-Ok;Chun, Mi-Son;Kang, Seung-Hee;Kim, Hyun-Sook
    • Journal of Nutrition and Health
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    • v.42 no.7
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    • pp.605-614
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    • 2009
  • Most cancer patients are treated with surgery, chemotherapy or radiation as anticancer therapies. Especially in the case of radiation, these treatments produce adverse effects such as vomiting, weight loss, anorexia, normal cell damage and malabsorption. The major goal of this study was to determine the effect of irradiation on the nutritional and immune status in irradiated rats. A secondary goal was to determine the effectiveness of high protein diet (HP) and resveratrol (Res) in minimizing the adverse effects of radiation. Rats were divided into four groups: normal diet (NP), HP, NP + Res and HP + Res groups. Each group was further divided into subgroups that received radiation (RT group) and one that did not (non-RT group). Each diet was supplied from $12^{th}$ day prior to irradiation treatment with irradiation dose of 17.5 Gy. The diets were continued until 10th day after radiation treatment and animals were sacrificed. The radiation treatment showed decreased body weight, serum protein and HDL levels and increased TG and LDL levels in nutritional status. HP, NP + Res and HP + Res groups reduced the level of serum LDL and TG in irradiated rats. NP + Res and HP + Res groups increased reduced albumin level of serum in RT group. In case of immune status, the radiation treat-ment showed decreased WBC, lymphocytes and increased neutrophil and eosinophil levels. The levels of serum IL-2 and IL-6 were significantly increased by radiation, however the cytokine levels decreased in all dietary treatment groups. These results showed that high protein diet and resveratrol supplementation seem to minimize the adverse effects of radiation on lipid nutritional status and inflammation response in the rat model.

Radiation Effect of X-Ray and Thermal Neutron on Robinia pseudoacacia L. and Some Other Species (아까시나무외 몇 수종(樹種)에 대(對)한 X-Ray와 Thermal Neutron의 조사효과(照射効果))

  • Kim, Chung Suk;Lee, Suk Koo;Hyun, Sin Kyu
    • Journal of Korean Society of Forest Science
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    • v.17 no.1
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    • pp.1-15
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    • 1973
  • In an effort to improve the major tree species in Korea, the seed of Robinia pseudoacacia, Pinus rigida, Pinus densiflora, Pinus thunbergii and Larix leptolepis were treated with X-ray and thermal neutron at the Brookhaven National Laboratory, and germination rate of the seed and some characteristics of the seedlings from irradiated seed were investigated and the results were summarized as follows. 1. The germination rate of the irradiated seed of Robinia pseudoacacia, Pinus densiflora, Pinus thunbergii and Pinus rigida was decreased, when the irradiation time of thermal neutron increased from 3 hours to 9 hours. The seed of Larix leptolepis was completely died out in all range of irradiation time. 2. The seed of Pinus densiflora, Robinia pseudoacacia and Pinus rigida showed low germination rate, when the dosage of radiation increased in the range of 10,000r-30,000r X-ray. This dosage of radiation was almost lethal to the seed of Pinus thunbergii and Larix leptolepis. 3. The growth rate of radiated Robinia pseudoacacia has been decreased when the dosage of X-ray and thermal neutron increased. However, the trees treated with thermal neutron for 3 hours showed 14.9 percent-increase in seedling height and some thornless individuals appeared in this treatment. 4. Individuals with variegated leaf, rugose leaf and albino were appeared in X-ray and thermal neutron treatment. 5. Abnormal mitosis of somatic cell, cell with two nucleoli, cell with two nuclei and chromosome clump in mitosis of somatic cell were observed in Robinia pseudoacacia irradiated with thermal neutron. 6. Resistanty against pawdery mildew was decreased in Robinia pseudoacacia radiated with X-ray and thermal neutron. 7. Length of stomata did not show any difference however number of stomata per unit area decreased in Robinia pseudoacacia radiated with thermal neutron. The leaves of Robinia pseudoacacia radiated with thermal neutron were thicker than those of non-treated one, but width of palisade tissue was decreased. The most sensitive one among those species to the thermal neutron treatment was Larix leptolepis, followed by Pinus densiflora, Robinia pseudoacacia, Pinus thunbergii and Pinus rigida in the order. In X-ray treatment, the most sensitive one was Larix leptolepis, followed by Pinus densiflora, Pinus thunbergii, Pinus rigida and Robinia pseudoacacia in the order. Morphological, cytological variation of the radiated Robinia pseudoacacia seemed to indicate some possibility to be used for tree improvement.

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A Study on the New Impedance Matching method by using Non-Symmetrical coupled Lines for MIC and MMIC (MIC와 MMIC를 위한 비대칭 결합 선로에 의한 새로운 임피던스 정합 방법에 관한 연구)

  • 강희창;진연강
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.13 no.6
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    • pp.521-528
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    • 1988
  • Into the telecommunications industry, which had been monopolistic, a few advanced countries introduced competition through 70's and 80's. And this trend is going on worldwide. The introduction of competition into the industry is made mainly in the long distance, international and enhanced market. This liberalisation results from the fundamental change of the cost function. Suggesting that the cost comprises of that of the facility sector and that of the operation sector there exists the economies of scale in the facility sector in general. The major ground for the monopolistic industrial structure in the past was the natural monopoly depending on the economies of scale. But the rapid advance of the technology by a large margin. This decrease has resulted in the change of the cost function. That is while there exists the economies of scale in the smaller production scale, the average cost increases beyond a certain scale. This means that the natural monopoly collapsed, and that the competitive structure is more efficient than the monopolistic structure. But, because there exists economies of scale in the smaller scale, the desirable number of players, which could result in efficient industry structure depends on the market size. Such correlation between technological level market size and the degree of regulation is found in the case of U.S.A., Japan and U.K., where deregulation policy of the telecommunications market has already been carried out. In U.S.A., which has the largest market and the highest technological level the degree of regulation is lowest. Also in the order of Japan and U.K. the regulation is severer. Japan and U.K. are likely to liberalize still more, as the technology advances and the market grows. This article is just the beginning of the research, and this hypothesis requires more detailed research.

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